Feel Better Safely

It seems only fair that pregnancy should be accompanied by a nine-month reprieve from everyday pain and allergy symptoms, but as many an expectant hay-fever sufferer will tell you, that's just not the case. However, before reaching for your usual over-the-counter (OTC) medication or trying something new to help you feel better, consult our guide below and speak with your doctor.

"Just because you don't need a prescription for it doesn't mean something is safe during pregnancy," says William Camann, M.D., an expert on pain relief during pregnancy and co-author of Easy Labor: Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth (Ballantine). "On the other hand, you don't have to be miserable." Whether you suffer from seasonal allergies or the occasional bout of pain, follow these suggestions regarding OTC medications.

Allergy MedicationsSafe in recommended doses The antihistamines of choice are loratadine (Claritin, Alavert) and chlorpheniramine (Chlor Trimeton), says Michael Schatz, M.D., chief of the Department of Allergy for Kaiser Permanente San Diego Medical Center. Because very little, if any, is absorbed into the bloodstream, the nasal decongestant spray oxymetazoiline (Afrin) is fine to use for up to three days—after that, you risk damaging nasal tissue, which could lead to chronic congestion. If you're still stuffed up, consider a saline spray, external nose strips (Breathe Right) or the anti-inflammatory nasal spray cromolyn (Nasalcrom).

Avoid in the first trimester To decrease the risk of birth defects, steer clear of certain medicines for the first three months of your pregnancy (they're OK after that). These include diphenhydramine (Benadryl) and all oral decongestants—sometimes labeled "non-drowsy formula" or with a "D," e.g., "Claritin D"—such as pseudoephedrine (Sudafed).

Alternatives to avoid High-dose vitamins, herbs such as herbal licorice, and other supplements touted to relieve allergy or pain symptoms are not regulated by the U.S. Food and Drug Administration and should be avoided throughout pregnancy, Schatz says. The herb ephedra (ma huang), sometimes used to treat asthma, should never be taken during pregnancy; it's believed to increase fetal heart rate and may stimulate uterine contractions.

Avoid in certain circumstances Unless your doctor instructs you otherwise, aspirin should not be taken during pregnancy because of its blood-thinning effects. Some studies have shown a link between nonsteroidal anti-inflammatory drugs (NSAIDs)—such as ibuprofen (Advil, Motrin), ketoprofen (Orudis) and naproxen (Aleve)—and first-trimester miscarriage, though many OB-GYNs will OK moderate doses if necessary until your third trimester. After that, such drugs may lead to problems with the formation of blood vessels in the baby's heart.

Safe alternatives Acupuncture with a licensed practitioner who knows you're pregnant; massage by a therapist certified in prenatal massage.

Asthma During Pregnancy In women with mild asthma, pregnancy tends to either improve or worsen symptoms, according to a federal study published in 2003. If you're one of the unlucky ones, you don't have to suffer for your baby's sake: "The benefits of using recommended asthma medication outweigh the risk to the fetus," says Kathryn Eisermann-Rogers, M.D., an allergist in Miami. "Uncontrolled asthma has been associated with low birth weight and other fetal complications." The common inhaler medication albuterol is safe to use throughout pregnancy, says Kaiser Permanente allergist Michael Schatz, M.D. If you have asthma, continue to see your allergist or pulmonologist regularly.